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International Journal of Clinical & Medical Images

2376-0249

Clinical-Medical Image - International Journal of Clinical & Medical Images (2022) Volume 9, Issue 9

When Distal lumen of a Central Venous Catheter of Hemodialysis does not return blood : A case report

When Distal lumen of a Central Venous Catheter of Hemodialysis does not return blood : A case report

Author(s): A.R. Idihia*, O. Benlenda, Y. Hadzine, K. Mellali, I. Kribou, A. El Mekkaoui, H. Nassik

Department of Anaesthesiology and Reanimation, University Hospital Souss Massa, Faculty of Medicine and Pharmacy Ibn Zohr University Agadir, Morocco

*Corresponding Author:
A.R. Idihia
Department of Anaesthesiology and Reanimation
University Hospital Souss Massa
Faculty of Medicine and Pharmacy Ibn Zohr University Agadir, Morocco
E-mail: ahmedreda.idihia@edu.uiz.ac.ma

Date of Submission: 12 September 2022, Manuscript No. ijcmi-22-76347; Editor assigned: 13 September 2022, Pre QC No. P-76347; Reviewed: 19 September 2022, QC No. Q-76347; Revised: 22 September 2022, Manuscript No. R-76347; Published: 30 September 2022, DOI:10.4172/2376-0249.1000846

Citation: Idihia AR. (2022) When Distal Lumen of a Central Venous Catheter of Hemodialysis does not Return Blood: A Case Report. Int J Clin Med Imaging 9:846.

Copyright: © 2022 Idihia AR. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Clinical-Medical Image

A 12 years old child was admitted to our Intensive Care Unit (ICU) with dialysis disequilibrium syndrome during an emergency dialysis session. He benefited previously of the placement of a two lumen 9Fr-13cm central venous catheter for haemodialysis in the left femoral vein (Figure 1a). 3 dialysis sessions later, the proximal lumen was not returning blood anymore, reason why we opted for the placement of a new haemodialysis catheter in the right femoral vein.

The patient was monitored with an electrocardiogram, a non-invasive blood pressure and a pulse oximeter. After putting the patient at the Trendelenburg position, Povidone iodine was used to clean the right femoral region and Lidocaine was used for local anesthesia and two sterile sheets were placed at the area. Using ultrasound and Seldinger technique, the insertion of the central venous catheter was achieved in one attempt [1,2]. Immediately after the placement, the proximal lumen was returning blood, but the distal lumen wasn’t [3]. Therefore, we verified the permeability of the right femoral vein and the intravascular position of the catheter using ultrasonography, then, we made an X-ray image who objectified an angled distal tip (Figure 1b), probably related to lack of dilatation. The catheter was removed immediately. When testing the removed catheter using a syringe filled with isotonic saline, the proximal lumen (Figure 2a) was permeable, while the distal lumen (Figure 2b) wasn’t, and a thrombus was removed manually from it (Figure 3).

Keywords

Central venous catheter; Hemodialysis

References

[1] Vetrugno L, Piccoli G, Costa MG, Pompei L, Chiarandini P, et al. (2012) The dos and do knots of central venous catheterization. J Clin Anesth 24:148-150.

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[2] Bannon MP, Heller SF and Rivera M. (2011) Anatomic considerations for central venous cannulation. Risk Manag Healthc Policy 4:27-39.

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[3] Pereira S, Preto C, Pinho C, Vasconcelos P. (2016) When one port does not return blood:two case reports of rare causes for misplaced central venous catheters. Braz J Anesthesiol 66:78-81.

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